In 2018 the number of names on the ‘811 Need a Family Practice Registry’ list increased nearly every month. At it’s peak there were 59,225 names on the list.
In April of that year, the province introduced the patient attachment incentive fund, which was created to improve access to primary care for Nova Scotians. The fund allowed eligible doctors to claim $150 for every new patient they took on. By November 2019, the incentive had helped to match 54,000 patients with a doctor.
But that incentive is coming to an end on March 1, 2020.
“It was always slated to be a limited term program,” said Health Minister Randy Delorey.
As the program winds down there are still tens of thousands of people in the province in need of a family practice. While nearly 73,000 people in Nova Scotia found a doctor over the past year, 52,000 added their name to the list.
As of January 1, 2020 there were 46,914 names on the ‘811 Need a Family Practice Registry’, down 11 per cent from January 1, 2019. Much of that decrease comes from the highly populated Central zone which includes the Halifax Regional Municipality. Between Jan. 1, 2019 and Jan. 1, 2020, the number of names on the list in the Central zone has dropped from 23,829 to 7,955, a decrease of 67 per cent.
But no other zone has seen a decrease. The Eastern zone, which includes Cape Breton has mostly remained unchanged, hovering around 4,500 names throughout the year. But the majority of people on the list are in the Northern and Western zone which have both increased over the year. The Western zone has increased by 25 per cent while the Northern zone has jumped by 73 per cent.
“Rural medicine involves specific challenges, and it is something that’s being worked on through Doctors Nova Scotia, the heath authority, and department of health,” said Dr. Gary Ernest, president of Doctors NS.
While the incentive to take on new patients is ending, a new master agreement is now in place and there is some hope it will address some of the current issues in the province.
“The answer there is not any incentive, the answer is going to be having more family doctors, because that’s what you need,” said Ernest.
Under the new agreement all doctors will receive a two per cent increase in each of the next four years. There is also targeted funding for a number of specialties which will see family, emergency and anesthesia doctors become the highest paid in Atlantic Canada.
“That addresses many of the recruitment and retention issues that are fiscal in nature,” said Delorey.
In addition to increased compensation, Ernest says the new agreement also addresses workplace satisfaction, which includes involving doctors in health care policy decisions and organized attempts to lessen paperwork burden.
“The combination of both should help to make family physicians more pleased with their work,” said Ernest.
“It’s all about work place satisfaction, looking at what can be done to incentive people to come into practice in Nova Scotia in general, both in the rural areas and urban areas,” he added.
The master agreement has also doubled the incentive for specialists in rural areas. This is in addition to efforts to train more doctors in rural areas. Last summer the province opened a new teaching site in Truro as part of ten new family medicine residency spaces that were added.
“We know exposing medical students and medical residents to practice in rural areas is one of the most effective recruitment tools,” said a statement from the Department of Health and Wellness.
Ernest says in addition to recruiting more doctors, part of the long term solution is turning to a more collaborative model with more nurse practitioners and family practice nurses being associated with family physicians to help extend their reach, something that is already starting to happen.
But for people anxiously waiting for a doctor in rural areas, the changes won’t solve the problem instantly.
“They should start to see a change year by year,” said Ernest.
“It’s going to be slow, it’s not going to be anything earth shattering. Slow but steady.”